Remission from Diabetes

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Wibble

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Type 2
Hello,
I was diagnosed with type two in Feb of this year. Following advice, I stopped drinking alcohol, was careful to watch what I was eating and lost just over 4 stone in weight. I had been on Metformin but have fairly recently stopped taking this. My blood sugar level is now consistently at a safe level. The nurse that has been looking after me at my health centre is delighted with my progress, as I am.
It appears that I am in remission and have carried on with my drinking and eating regime as this seemed to be a sensible thing to do; my nurse agreed. Providing I keep on the straight and narrow am I to assume that I will be able to remain in remission? Any advice would be gratefully received.
 
I don't think there's enough long-term scientific evidence to say very much for T2's in general, and things will be different for each individual.

The most recent data from the two-year follow-up to the DUK-funded DiRECT remission-via-weight-loss trial showed 36% in remission at 24 months, rising to 64% of those who maintained at least 10kg weight loss, and 70% of those with 15kg+ loss. Abstract: https://www.ncbi.nlm.nih.gov/pubmed/30852132

Sustained remission was linked to the extent of sustained weight loss.

Full paper: https://www.ncl.ac.uk/media/wwwncla...nancecentre/files/DiRECT - 2 year results.pdf

The two-year results of DiRECT demonstrate continuing remission of type 2 diabetes is possible. The present data demonstrate that diabetes is reversible to a non-diabetic state over 24 months for 36% of the whole Intervention group and for 70% of those who maintain a weight loss of over 15kg. The data extend the 1st year data of DiRECT in showing that achieving and maintaining weight loss is the dominant factor behind remission of type diabetes. Participants reverting to diabetes between 12 and 24 months regained more weight than those maintaining remission. The co-primary outcome of >15kg weight loss was maintained by 11.4% (17/149) by intention to treat analysis, down from 24% (36/149) at 1 year. Blood pressure, lipids and quality of life improved with the intervention. There were less serious adverse events in the intervention group in the second year. The overall diabetes-related cardiometabolic risk profile improved, with reduced lipids and fewer participants requiring antihypertensive medications to control blood pressure than in the control group.

So nothing is certain, but I'd say you have a good shot if you keep on track (I hope I do!)

All the best.

 
Sounds like you are doing great @Wibble

General feeling / experience on the forum is that remission can be maintained for some, but not for all - and that maintaining remission usually involves continuing to eat the types and amounts of foods that your body and metabolism can cope with. If you go back to eating large amounts of whatever you fancy or regain weight your system seems likely to struggle again.

Keep doing what you are doing!
 
I forgot this study from August: https://www.healio.com/endocrinolog...on-heightened-with-earlier-modest-weight-loss

Again looking at weight loss, but with a 5 year follow-up & bigger, looking at 800+ newly diagnosed T2's not given any particular wight loss intervention but just tracking how their weight, BG etc changed over time. They found 30% remission after 5 years, with a strong association between likelihood of remission and weight loss. Maintaining 10%+ weight loss from the first year thru the fifth corresponded to 2.4X greater likelihhod of remission. Obviously, for many people, losing 10% of body weight would be an easier ask than losing the 10kg+ or 15kg+ involved in the DiRECT results.
 
I think that the weightloss factor is a bit of a red herring - I believe my weightloss was as a result of keeping my blood glucose in the normal range.
During the time I was losing weight I did not even think about any of the usual methods of losing weight, I concentrated solely on low carb foods and normal blood glucose levels.
Unofficially I think I could have lost 60lb - I stopped weighing myself several months before diagnosis still eating the high carb diet supposed to lower my cholesterol.
I was not officially in remission until about 6 months ago, after a couple of years at 41/42 levels of Hba1c - bu I thing my GP practice is not being run very well when it comes to diabetes management. I have been called in for a supposed diabetes review only to find out it is just to check my weight.
 
Eddy Edson said:
I don't think there's enough long-term scientific evidence to say very much for T2's in general, and things will be different for each individual.

The most recent data from the two-year follow-up to the DUK-funded DiRECT remission-via-weight-loss trial showed 36% in remission at 24 months, rising to 64% of those who maintained at least 10kg weight loss, and 70% of those with 15kg+ loss. Abstract: https://www.ncbi.nlm.nih.gov/pubmed/30852132

Sustained remission was linked to the extent of sustained weight loss.

Full paper: https://www.ncl.ac.uk/media/wwwnclacuk/newcastlemagneticresonancecentre/files/DiRECT - 2 year results.pdf

The two-year results of DiRECT demonstrate continuing remission of type 2 diabetes is possible. The present data demonstrate that diabetes is reversible to a non-diabetic state over 24 months for 36% of the whole Intervention group and for 70% of those who maintain a weight loss of over 15kg. The data extend the 1st year data of DiRECT in showing that achieving and maintaining weight loss is the dominant factor behind remission of type diabetes. Participants reverting to diabetes between 12 and 24 months regained more weight than those maintaining remission. The co-primary outcome of >15kg weight loss was maintained by 11.4% (17/149) by intention to treat analysis, down from 24% (36/149) at 1 year. Blood pressure, lipids and quality of life improved with the intervention. There were less serious adverse events in the intervention group in the second year. The overall diabetes-related cardiometabolic risk profile improved, with reduced lipids and fewer participants requiring antihypertensive medications to control blood pressure than in the control group.

So nothing is certain, but I'd say you have a good shot if you keep on track (I hope I do!)

All the best.
Click to expand...
Many thanks for all of the information that you supplied Eddy. I can but try and if I keep up with what I have already done ... who knows? I think that cutting out alcohol, altogether, has played a major part in my case. I was drinking far too much and it was just piling on the calories. I am also eating far more sensibly with smaller portions. I don't eat any red meat; haven't done for a long time and hardly eat any poultry these days. I have a salad for lunch and eat the right kinds of fruit. We will see!

All the best

Anton
 
everydayupsanddowns said:
Sounds like you are doing great @Wibble

General feeling / experience on the forum is that remission can be maintained for some, but not for all - and that maintaining remission usually involves continuing to eat the types and amounts of foods that your body and metabolism can cope with. If you go back to eating large amounts of whatever you fancy or regain weight your system seems likely to struggle again.

Keep doing what you are doing!
Click to expand...

Thanks for the encouragement! I certainly have no intention of letting things slip! My current 'regime' is absolutely fine and if it keeps my blood sugar down I am very happy. I was in quite a state in Feb and have no wish to return there at all.

Thanks

Anton
 
Drummer said:
I think that the weightloss factor is a bit of a red herring - I believe my weightloss was as a result of keeping my blood glucose in the normal range.
During the time I was losing weight I did not even think about any of the usual methods of losing weight, I concentrated solely on low carb foods and normal blood glucose levels.
Unofficially I think I could have lost 60lb - I stopped weighing myself several months before diagnosis still eating the high carb diet supposed to lower my cholesterol.
I was not officially in remission until about 6 months ago, after a couple of years at 41/42 levels of Hba1c - bu I thing my GP practice is not being run very well when it comes to diabetes management. I have been called in for a supposed diabetes review only to find out it is just to check my weight.
Click to expand...

I reckon that weight loss may well be a red herring for some but consider it to be central to my improvements to date. Your GP practice certainly looks as though it needs to buck up its ideas regarding diabetes management. I am very fortunate to have a senior nurse who is very knowledgeable on the subject.

All the best,

Anton
 
Good work Wibble, there is always a chance of a wobble but you know what works so can get back into wobble free zone :D Congratulations.
🙂
 
zoombapup said:
Are you actually saying that Wibble might wobble, but he won't fall down? :D

Sorry, couldn't resist.
Click to expand...
ha ha yes, well its Christmas coming up and I'm wobbling already with some naughty goodies and its not all jelly :D although I do like the sugar free jellies :D 😛
 
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